Pineal Tumors (cont.)
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Pineal Tumor Symptoms
Pineal region tumors arise in or near the pineal gland, which is a small midline structure located deep in the midbrain area, near many vital structures. The pineal gland is located next to the aqueduct of Sylvius, which serves as a passage allowing cerebrospinal fluid (CSF) to leave the center of the brain where it is first produced. Pineal tumors often compress this aqueduct, causing a build up of pressure of CSF in the brain (called hydrocephalus). Blockage of the flow of this fluid can cause some of the common presenting symptoms of these tumors, which include:
The intracranial pressure may even increase to life-threatening levels, demanding urgent treatment.
Hydrocephalus can be treated by placement of a ventriculo-peritoneal shunt (VP shunt). The VP shunt is a long tube placed within one of the CSF-containing spaces of the brain, then passed under the skin to the abdominal cavity to provide a pathway for CSF drainage and absorption in the abdomen.
Alternatively, the hydrocephalus can be controlled by a procedure known as a stereotactic third ventriculostomy. Third ventriculostomy creates a tiny opening in the bottom of the brain using a small endoscope to allow the CSF to escape. This procedure is usually performed under local anesthesia (without the need for general anesthesia).
Pineal region tumors may also cause visual changes as a result of involvement of the nearby tectal region which has a primary role in controlling eye movements. These changes may include:
These problems may improve or resolve with treatment of the tumor. Certain germ cell tumors may secrete hormones which cause endocrinologic disturbances, such as early onset of puberty in children.
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